Role of peroral cholangioscopy in the diagnosis of primary sclerosing cholangitis

Aim . To demonstrate the therapeutic and diagnostic capabilities of peroral cholangioscopy in the diagnosis and symptomatic treatment of primary sclerosing cholangitis. Materials and methods . Due to the presence of undifferentiated stricture, according to instrumental examination methods, peroral cholangioscopy was performed in the presented case. The SpyGlass DS II (Boston Scientific) biliary tract endoscopic imaging system was used as a daughter device. Intraductal biopsy was performed using SpyBite Max forceps. Taking into account the visual picture of intrahepatic cholangiolithiasis, large stones, contact laser lithotripsy using a thulium laser was performed for curative purposes. Results . Visual examination of the biliary tree and intra-flow biopsy confirmed the diagnosis of primary sclerosing cholangitis. The use of contact laser lithotripsy made it possible to carry out adequate drainage. Conclusion . The peroral cholangioscopy technique allows for targeted biopsy of altered tissues under double (endoscopic and X-ray) control, is effective and relatively safe in the differential diagnosis of various lesions of the bile ducts.